To Overcome Rapid Ejaculation We Need
To Know What It Is!

Is There
An Accurate Definition of Premature Ejaculation?

Diagnosis & Definition

Premature ejaculation is often defined by
two things - first, the time between penetration (intromission) and
ejaculation is two minutes or less (though some experts use three
minutes as a cut off point), and second, there is distress of some kind
for either the man or his sexual partner because lovemaking is so brief.

From the man's point of view, this means
he has reduced
control over ejaculation; he is dissatisfied with
intercourse, and he or his partner are distressed about it.

Since
many men do not apparently mind that they can make love in bed for so
short a length of time - less than two minutes - before they ejaculate,
the added factor of "distress" is needed.

In reality, substantial overlap exists
between men who say they have premature ejaculation and those who don't
when the length of lovemaking alone is used alone as a defining feature
of the condition.

When men are asked to estimate how long
they are capable of making love for, they are found to overestimate the
time somewhat: men with PE think they can make love for 2 minutes,
when the actual average is 1.8 minutes.

Men without PE estimate their
capacity at 9 minutes when they can actually make love for 7.3 minutes.
A massive difference in duration, really, and one which is very likely to affect
the ease
with which a woman can come during intercourse.

By these criteria, premature ejaculation is present in at least 35% of
males over 18 years of age. It's also not surprising to find that
premature ejaculation is the most common
male sexual
dysfunction with erectile dysfunction and decreased libido close
behind.

Men who can't control ejaculation in
the bedroom are obviously much less happy about the quality of their
sexual relationship, the duration of sex, and the period of time they
spend with their partner.

So according to the definition of PE
in the
DSM IV, coming too soon has to cause distress and/or interpersonal
problems to be considered early ejaculation, which is - to say the least
- a very subjective definition, An untimely coming, one might say!

Of course, both the DSM IV and ICD-10 methods of defining PE are
opinion-based, and do not have the backing of controlled clinical and
epidemiological research studies.

So that means the DSM IV definition of
prematurity has little value as a diagnostic test for predicting PE. The
key thing here, as you may have realized, is that there is no definition
of the time between penetration and ejaculation (also called the
intravaginal ejaculatory latency time or for short the IELT).

And this means that men who "last a
long time during sex", i.e. who can thrust for up to 20 minutes or even
longer between penetration and ejaculation, may, according to the DSM
IV, have premature ejaculation if they simply have some doubts or
worries about how long they can last. Confused? Go to bed and put an
ice-pack on your head! Lie there for as long as you want, but don't get
up prematurely!!

Worse, there are plenty of men who last
for a long time in bed and yet who complain that they have premature
ejaculation. All in all, the unspecific and vague DSM IV definition is
unhelpful in clinical practice and does not aid research into new
methods of treatment.

A New Definition

The DSM IV definition of premature
ejaculation emphasizes the subjective nature of premature ejaculation as
a "complaint" from which men suffer. And the imprecise nature of the
term "interpersonal distress" leaves the definition open to further
subjective interpretation.

But worry no longer! Proposals for
a new definition have been put forward: an approach which would elevate
premature ejaculation from the subjective sense of "I'm not lasting long
enough in bed" or "how can I last
longer during sex" to a so-called syndromal approach which incorporates
carefully conducted clinical studies which measure the time between
penetration and ejaculation.

Premature ejaculation as a discrete clinical entity,
a medical syndrome,
was first described in 1943 by Schapiro, who drew a distinction between
what was to become known as lifelong premature ejaculation and acquired
premature ejaculation. More recently, Waldinger and Schweitzer
suggested the existence and definition of a third premature
ejaculation syndrome called "natural variable premature ejaculation".

And, in order to help the classification even further, Waldinger also
suggested that a fourth premature ejaculation syndrome be called
premature-like ejaculatory dysfunction - this is the condition
experienced by men who last long enough while bedding a woman but who
still claim they have premature ejaculation!

Delayed Ejaculation

Lifelong PE

a man's ejaculation occurs too early
on almost every occasion he and his partner have sex

the problem is not limited to one
woman but happens almost every
time the man has intercourse with any partner

the man has premature ejaculation from
the first time he has sex onwards

up to 80% of men ejaculate within 30-60
seconds of penetration and the other 20% ejaculate within 1-2 minutes

in 70% of these men ejaculation remains
very quick throughout
life; in another 30% it may get even faster with age

a number of men ejaculate during foreplay,
before they have penetrated their partner or as soon as their penis touches
their partner's vagina.

Acquired PE

Acquired premature ejaculation is
different. It shows the following symptoms:

early ejaculation starts at some point in a man's life

the man has
usually experienced normal ejaculation before the start of his complaint

the premature ejaculation comes on
either suddenly or gradually and may even be secondary to something
like erectile dysfunction or
prostatitis. It may also be caused by thyroid dysfunction,
psychological problems and relationship issues.

Acquired premature ejaculation
can be treated by addressing the underlying cause. A physical
examination and a blood
and/or urine test are always necessary.

Natural Variable PE

In natural variable premature
ejaculation, the ejaculation time varies, and the rapid ejaculation
occurs occasionally or regularly in various situations or circumstances.
Duration aside, this
is rather like a normal variation in sexual performance, and it
involves the following
symptoms:

rapid ejaculations are not consistent
and happen irregularly or unexpectedly

a man's capacity to control ejaculation may be
less than normal or lacking, but a
diagnosis can be made without this symptom

reduced control of ejaculation is
linked to a short or normal ejaculation time of less than 1.5
minutes

Men with this type of
premature ejaculation usually cope well, but need to regain
sexual confidence, for which therapy is helpful, because the problem
is related to situational problems and should be quickly reversible

treatment with ejaculation-delaying
drugs is not needed

Premature-Like Ejaculatory Dysfunction

Premature-like ejaculatory dysfunction is a syndrome in men who say
they have premature ejaculation despite the fact that they last as
long as most men in bedding - 3-6 minutes - and they may even be capable of
prolonged sex of up to 20 minutes.

it is more a psychological condition than a true pathology

it is often caused by psychological and/or relationship issues

men with this condition think they regularly or sometimes ejaculate far too
soon during sex

they may become obsessed with their
supposed early ejaculation or
lack of control, even though their IELT is in the normal range

they may or may not lack the ability to stop ejaculation at the
point of no return, the so-called point of imminent ejaculation, but
this is not a prerequisite for the diagnosis

they don't have another emotional disorder which explains the way they
are behaving

assurance that ejaculation time is inside the normal range and telling
them emotional issues are most probably the cause usually helps, if not, counseling,
sex-education, and psychotherapy of uncertain duration are needed.